Economic burden and associated factors of measles patients in Zhejiang Province, China

Figures & data

Table 1. Characteristics of 136 measles cases in Zhejiang Province, 2015.

Characteristics	No. of cases	%
Gender
Male	63	46.32
Female	73	53.68
Age
<8 months	26	19.12
8 months–18 months	9	6.62
18 months–15 y	12	8.82
≥15 y	89	65.44
City
Jiaxing	45	33.09
Jinhua	51	37.50
Taizhou	40	29.41
Hospitalization
Yes	112	82.35
No	24	17.65
Occupation
Children, student	47	34.56
Civil servants, commercial service	21	15.44
Farmer, worker	48	35.29
Jobless, retired	20	14.71
Vaccination
Yes	6	4.41
No	39	28.68
Unknown	91	66.91
Major means of payment
Medical insurance	75	55.15
Self-pay	61	44.85
Complication
None	102	75.00
Pneumonia	16	11.76
Diarrhea	16	11.76
Tracheitis	1	0.74
Encephalitis	1

Table 2. Costs of measles patient (USD) in Zhejiang, 2015.

Item	Overall*	Average	% of total cost
Direct cost	101610.49	747.14	58.96
Outpatient expenditure	11464.56	84.30	6.65
Hospitalization expenditure	84846.43	623.87	49.23
Self-treatment and nutrition supplements	5299.50	38.97	3.07
Indirect cost	70736.81	520.12	41.04
Transportation fee	3038.92	22.34	1.76
The cost of work loss due to measles for adult cases	38528.37	283.30	22.36
The cost of work loss due to looking after patient	29097.27	213.95	16.88
The cost of hiring health-care worker	72.25	0.53	0.04
Total cost	172347.31	1267.26	100.00

Note: *Overall means all the 136 cases in the survey.

Table 3. Univariate analysis of the factors associated with the economic burden (USD) of measles cases in Zhejiang, 2015.

Influencing factor	Direct cost	Indirect cost	Total cost
City
Jiaxing	695.92	411.78	1107.70
Jinhua	763.64	508.63	1272.27
Taizhou	783.72	656.66	1440.39
χ^2	2.33	4.08	4.27
p Value	0.31	0.13	0.12
Age
<8 months (1)	986.95	355.86	1342.81
8 months–18 months (2)	543.11	295.54	838.65
18 months–15 y (3)	378.53	612.29	990.82
≥15 y (4)	720.52	573.95	1294.47
χ^2	8.62	4.60	1.32
p Value	0.04	0.20	0.73
Occupation
Children, student (1)	797.54	418.20	1215.74
Civil servants, commercial service (2)	615.61	582.71	1198.32
Farmer, worker (3)	793.79	678.43	1472.22
Jobless, retired (4)	654.80	314.00	968.81
χ^2	4.47	22.66	12.30
p Value	0.22	0.00	0.01
Vaccination
Yes	544.38	597.52	1141.90
No	860.87	392.72	1253.59
Unknown	711.76	569.62	1281.39
χ^2	0.99	3.09	0.12
p Value	0.61	0.21	0.94
Hospitalization
Yes	879.35	544.99	1424.34
No	130.13	404.10	534.24
Z	−7.46	−1.17	−5.59
p Value	0.00	0.24	0.00
Gender
Male	713.71	527.91	1241.62
Female	775.98	513.40	1289.39
Z	−0.32	−0.72	−0.27
p Value	0.75	0.47	0.79
Complication
With	1034.37	757.76	1792.13
Without	651.39	440.91	1092.30
Z	−3.15	−2.08	−3.38
p Value	0.00	0.04	0.00
Insurance
With	907.11	615.39	1522.50
Without	550.45	402.99	953.44
Z	−4.44	−1.91	−3.87
p Value	0.00	0.06	0.00

Table 4. Analysis of ordinal logistic regression model on total cost in Zhejiang, 2015.

Factors	Estimate	OR	Std. error	Wald	df	p Value	95% CI
							Lower bound	Upper bound
Total cost = 1	5.422		1.303	17.308	1	0.000	2.868	7.977
Total cost = 2	9.459		1.541	37.661	1	0.000	6.438	12.480
Age	0.060	1.062	0.026	5.409	1	0.020	0.009	0.110
Income	−0.024	0.976	0.025	0.941	1	0.332	−0.074	0.025
Duration days	0.172	1.187	0.041	17.256	1	0.000	0.091	0.253
Site = Jiaxing	−1.688	0.185	0.555	9.269	1	0.002	−2.775	−0.601
Site = Jinhua	−0.763	0.466	0.531	2.067	1	0.150	−1.803	0.277
Site = Taizhou*	0				0
Sex = Male	0.165	1.179	0.419	0.155	1	0.694	−0.657	0.986
Sex = Female*	0				0
Occupation = 1	2.603	13.499	2.056	1.602	1	0.206	−1.427	6.632
Occupation = 2	1.585	4.882	0.824	3.698	1	0.054	−0.031	3.201
Occupation = 3	2.269	9.673	0.731	9.647	1	0.002	0.837	3.701
Occupation = 4*	0				0
Vaccination = No	−0.671	0.511	1.839	0.133	1	0.715	−4.276	2.933
Vaccination = Yes	0.279		2.009	0.019	1	0.889	−3.658	4.216
Vaccination = Unclear*	0				0
Hospitalization = Yes	3.703	40.579	0.704	27.659	1	0.000	2.323	5.083
Hospitalization = No*	0				0
Insurance = Yes	−0.382	0.683	0.488	0.613	1	0.434	−1.338	0.574
Insurance = No*	0				0
Complication = Yes	1.102	3.009	0.517	4.541	1	0.033	0.088	2.115
Complication = No*	0				0

Note:* was set to be the reference value.

Table 5. QALYs for measles patients in Zhejiang, 2015.

Status	Utility weights (wi)	Survival years (yi)	wiyi
Measles	0.532	0.030^a	0.016
Healthy	1	76.070^b	76.070
Total	-	76.100^c	76.086

Note: a survival years of measles status = the median duration days of measles patients.

b survival years of healthy status = c – a.

c Life expectancy at birth in China in 2015 was 76.1 y according to the World health statistics 2016.